老年患者使用清开灵注射液的疾病特征及联合用药分析  

Analysis on the disease characteristics and combined medication with qingkailing injection in the elder patients

作　　者：柴露露 谢雁鸣[1] 王连心[1] 王群[3] 贾萍萍[4] 凤博 CHAI Lu-lu;XIE Yan-ming;WANG Lian-xin;WANG Qun;JIA Ping-ping;FENG Bo(Institute of Clinical basic Medicine of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100700;Beijing Industrial Hospital,Beijing 100124;Statistics School,China People′s University,Beijing 100872)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院西苑医院,北京100700 [3]北京工业大学,北京100124 [4]中国人民大学统计学院,北京100872

出　　处：《世界中西医结合杂志》2019年第8期1142-1147,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金面上项目(81473798);国家“重大新药创制”科技重大专项“清开灵注射液安全性研究”(2014ZX09201022-005);北京市中医药科技专项“中西药联合应用评价及机制的方法研究”(JJ2014-53);国家中医药管理局中医药行业科研专项项目(201507003)

摘　　要：目的分析使用清开灵注射液的老年患者疾病特征及联合用药情况。方法基于中国中医科学院中医临床基础医学研究所构建的HIS数据仓库,提取65岁以上老年患者,分析性别、年龄等一般人口学信息、西医诊断、中医诊断、用药信息等,对中药联合用药、西药联合用药以及中西药联合用药特点进行讨论与总结。采用Apriori算法建立模型,使用Clementine 12.0对数据进行关联分析。结果使用清开灵注射液的患者年龄主要分布在65~75岁,平均74岁;主要分布在神经科、呼吸科、皮肤科、肿瘤科、消化科、心血管科、内分泌科、急诊科、针灸科等,其中神经科患者最多;以门诊方式入院居多,共2922例,占79.58%,在“一般”“急”“危”各个病情阶段都有所应用;最常合并的疾病为高血压(1148例,30.46%)、缺血性脑血管病(927例,24.60%)、上呼吸道感染病(886例,22.45%)、糖尿病(602例,15.97%)、恶性肿瘤(495例,13.13%)、肺炎(379例,10.06%);中医辨证主要为痰湿内阻证(199例,28.72%)、阳气虚衰证(133例,19.19%)、气阴两虚证(91例,13.13%)、肝气郁结证(65例,10.68%);患者入院率排前3位的节气为冬至(232例,6.16%)、小寒(218例,5.78%)、立夏(173例,4.59%)。清开灵注射液治疗老年患者联合两种西药使用时,临床最常联合用药为维生素C+头孢注射液组合(支持度34.2);联合两种中药使用时,最常联合用药为感冒清热颗粒+鲜竹沥口服液组合(支持度6.9);联合3种西药使用时,最常联合用药为注射用头孢注射液+胰岛素+维生素C组合(支持度22.0);联合3种中药使用时,最常联合用药为生脉注射液+醒脑静注射液+鲜竹沥口服液(支持度1.72)。结论清开灵注射液主要使用于神经科、呼吸科等;老年患者常合并的疾病为高血压、缺血性脑血管病、上呼吸道感染病等;中医证候中以痰湿内阻、阳气虚衰最为常见。中医、西医联合用药最常见的都是为�Objective To analyze the disease characteristics and combined medication with qingkailing injection in the elder patients. Methods From HIS database established in Institute of Clinical basic Medicine of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,the general demographic information,e. g. sex and age,diagnosis in Western medicine and TCM and drug use in the aged patients over 65 years old were collected. The characteristics of the allied medication of Chinese herbal drugs,the allied medication of western drugs as well as the combination of Chinese and western drugs were analyzed. The model was established with Apropri algorithm. Clementine 12. 0 was adopted for the association analysis on the data. Results The patients using qingkailing injection were aged from 65 to 75 years,distributed in the departments of neurology,respiration,dermatology,oncology,digestion,cardiovascular medicine,endocrinology,emergency and acupuncture,of which,the patient number was predominated in neurology department. Most patients were outpatient transfer,totally 2922 cases,accounting to 79. 58%. This drug was used in the general,acute or critical stage of illness. The most common complications were hypertension(1148,30. 46%),ischemic cerebral vascular disease(972,24. 60%),upper respiratory infection(886,22. 45%),diabetes(602,15. 97%),malignant tumor(495,13. 13%),pneumonia(379,10. 06%);retention of phlegm damp(199,28. 72%),yang qi declining(133,19. 19%),qi and yin deficiency(91,13. 13%),liver qi stagnation(65,10. 68%) in TCM differentiation. The top three administration rates happened at the Winter Solstice(232,6. 16%),the Lesser Cold(218,5. 78%) and the Beginning of Summer(173,4. 59%). When qingkailing injection was used in combination with two western drugs in elderly patients in clinic,the most commonly used combination was vitamin C + cephalosporium injection(34. 2 in support degree),When combined with two kinds of Chinese herbal medicines,the most commonly used combination was ganmao qingre granules + xian

关 键 词：清开灵注射液 老年患者 疾病特征 联合用药 

分 类 号：R286[医药卫生—中药学]